OBJECTIVE: Our aim is to emphasize the importance of patient participation in screening programs available in the Czech Republic and in preventive gynaecological examinations. As an example, we present a case report of a 77-year-old female patient with the accumulation of serious gynaecological diseases (extreme uterine myomatosis, breast cancer) and non-Hodgkin´s B-lymphoma. DESIGN: Case report. SETTING: Department of Obstetrics and Gynaecology, Faculty Hospital in Pilsen, Charles University Medical Faculty in Pilsen. CASE REPORT: Our case report of a 77-year-old patient is a rare case of the simultaneous detection of giant uterine myomatosis causing voluminous ventral hernia, invasive ductal breast cancer, and non-Hodgkin´s B-lymphoma. The patient was not gynecologically examined for last 20 years and did not undergo any screening examinations. In the postoperative period, the patient was diagnosed with invasive ductal breast cancer and follicular lymphoma. All the diseases were diagnosed in advanced stage. CONCLUSION: The occurrence of bulky fibroids is very rare in postmenopause. Long-term neglect of clinical symptoms and adverse health signals allows their gradual progression. Especially in older patients, other serious illnesses may complicate the situation.
- Klíčová slova
- breast cancer, giant uterine fibroid, non-Hodgkin´s B-lymphoma, ventral hernia,
- MeSH
- gynekologie * MeSH
- leiomyom * MeSH
- lidé MeSH
- nádory dělohy * komplikace diagnóza MeSH
- nehodgkinský lymfom * MeSH
- porodnictví * MeSH
- senioři MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Geografické názvy
- Česká republika MeSH
OBJECTIVE: The aim of this study was to assess the significance of bizarre cells (cells of squamous origin with a superficial squamous cell-type cytoplasm and characterised by multinucleation that produces bizarre nuclear shapes) in liquid-based cytology (LBC) Papanicoaou (pap) smears with clinical and histological follow-up correlation. METHODS: Fifteen patients, all with LBC samples containing bizarre cells, were identified in routine ThinPrep® LBC workload. HPV testing was performed in each case using residual LBC material. Cytological-histological correlations were reviewed. RESULTS: All 15 LBC samples contained bizarre cells and tested positive for high-risk HPV types. Ten of the 15 cases were identified as atypical squamous cells - cannot exclude an HSIL (ASC-H) with secondary diagnosis of low-grade squamous intraepithelial lesion (LSIL), while five cases were identified as high-grade squamous intraepithelial lesion (HSIL), and a subsequent biopsy was recommended. Additionally, 13/15 cases underwent cone biopsy or hysterectomy within 1-11 months, of which 10 showed histologically confirmed HSIL end-points. LSIL was present in three cases. Bizarre cells were identified in the HSIL epithelium of five cone biopsies. CONCLUSIONS: Identification of bizarre cells in LBC is straightforward and may facilitate diagnosis. The cytology of bizarre cells is associated with HSIL in cone biopsies. We recommend assigning LBC samples containing bizarre cells as ASC-H with secondary diagnosis of LSIL.
- Klíčová slova
- ASC-H, cervix, high-grade squamous intraepithelial lesion, human papillomavirus, liquid-based cytology, multinucleation,
- MeSH
- atypické dlaždicové buňky děložního čípku patologie MeSH
- dlaždicová intraepiteliální léze cervixu diagnóza patologie MeSH
- lidé MeSH
- Papanicolaouův test MeSH
- tekutá biopsie MeSH
- vaginální stěr MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: The article summarizes current possibilities of usage of the One-Step Nucleic Acid Amplification method (OSNA) in the perioperative management of sentinel lymph nodes in oncologic surgery. The principle of this method is the detection of cytokeratin 19 (CK19) in the lymphatic tissue as a marker of the metastatic spread. DESIGN: Review article. SETTINGS: Department of Obstetrics and Gynaecology, University Hospital Pilsen, Faculty of Medicine in Pilsen, Charles University, Prague; Department of Biology, Faculty of Medicine in Pilsen, Charles University, Prague; Department of Immunochemistry, University Hospital Pilsen, Faculty of Medicine in Pilsen, Charles University, Prague; Sikl´s Department of Pathology, University Hospital Pilsen, Faculty of Medicine in Pilsen, Charles University, Prague. METHODS: The review of the literature published until the end of April 2017 available on the PubMed database was performed. The official abbreviation OSNA and the full name of the method One-Step Nucleic Acid Amplification was used for search in this database. CONCLUSION: The usage of the OSNA method with the detection of CK 19 in the sentinel lymph nodes as a marker of metastatic spread to the lymphatic tissue currently represents an acceptable form of perioperative sentinel lymph node management in patients with breast and colorectal cancer. Until now published data are pointing towards possible successful application of this method in sentinel lymph node management in patients with some other malignancies, such as thyroid carcinoma, gastric cancer, uterus cancer and head and neck cancer. More data is needed to establish this method also in those neoplasms.
- Klíčová slova
- CK19 sentinel lymph node., OSNA,
- MeSH
- biopsie sentinelové lymfatické uzliny MeSH
- keratin-19 MeSH
- lidé MeSH
- lymfatické uzliny * MeSH
- messenger RNA MeSH
- nádory * diagnóza chirurgie MeSH
- sentinelová uzlina * MeSH
- techniky amplifikace nukleových kyselin * MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- keratin-19 MeSH
- messenger RNA MeSH
OBJECTIVE AND SETTING: A retrospective review of women of the West Bohemian population was performed at the Department of Gynaecology and Obstetrics, University Hospital in Pilsen, Czech Republic from 1/2005 - 1/2017. METHODS: The following data was analysed: patients age, histological type, tumour size, FIGO stage, body mass index, previous irradiation, Tamoxifen usage, and other possible risk factors. A total number of 20 uterine sarcoma patients were detected in the period from 1/2005 to 1/2015, and these cases were followed until 1/2017. RESULTS: The histological types identified were: leiomyosarcoma in 12 cases, endometrial stromal sarcoma in 7 cases and one case of high-grade undifferentiated uterine sarcoma. This only patient diagnosed with high-grade undifferentiated uterine sarcoma showed distant metastases 12 months after the surgical treat-ment and died one month later. The whole group of uterine sarcoma patients regardless histological subtype reached two years in 50% of cases, with the median disease-free interval 18 months and the median follow up of 38 months. The diagnosis of sarcoma was already known in 25% of cases from dilatation and curettage histology. There were suspicious sonographic findings suggestive of sarcoma in 10% of cases. Multiparity was associated with 48.2% of endometrial stromal sarcoma cases. The leading clinical symptom was postmenopausal bleeding in 55% of patients. CONCLUSION: We confirmed uterine sarcomas to be rare malignancies, even in the Czech population with high uterine malignancy incidence. Uterine cold knife morcellation during the vaginal part of laparoscopically assisted vaginal hysterectomy didnt worsen the prognosis of our patients.
- Klíčová slova
- cold knife morcellation Czech Republic., incidence, risk factors, uterine sarcoma,
- MeSH
- dítě MeSH
- dospělí MeSH
- gynekologie * MeSH
- hysterektomie MeSH
- incidence MeSH
- lidé MeSH
- nádory dělohy epidemiologie patologie MeSH
- nádory endometria * MeSH
- nemocnice univerzitní MeSH
- porodnictví * MeSH
- retrospektivní studie MeSH
- sarkom epidemiologie patologie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
OBJECTIVE: The case report presents a case of 60-year old woman with a rare malignant mixed Müllerian tumor with melanomatous differentiation diagnosed from a histology after cervical polyp ablation and curettage. DESIGN: Case report. SETTING: Department of gynecology and obstetrics, University Hospital in Pilsen. CONCLUSION: Carcinosarcoma, previously malignant mixed Müllerian tumor, is a very rare aggressive endometrial carcinoma with low incidence, which typically occurs among older women and commonly affects the uterine body and cervix. Clinically, the carcinosarcoma is impossible to be distinguished from endometrial carcinoma or uterine sarcoma and the definitive diagnosis can only be made based on histological examination.
- Klíčová slova
- carcinosarkoma, diagnostics, histology relapse., malignant mixed Müllerian tumor, radical surgery,
- MeSH
- endometrium MeSH
- karcinosarkom patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory dělohy patologie MeSH
- nádory endometria patologie MeSH
- smíšený nádor Müllerův patologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- MeSH
- lidé MeSH
- mladý dospělý MeSH
- nádory komplexní a smíšené patologie chirurgie MeSH
- nádory vaječníků patologie chirurgie MeSH
- oligodendrogliom patologie chirurgie MeSH
- teratom patologie chirurgie MeSH
- Check Tag
- lidé MeSH
- mladý dospělý MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Small cell carcinoma of the ovary (SCCOHT) is a rare tumor typically affecting young women. It is a highly malignant tumor accompanied with poor prognosis, early relapse and low survival rates. The most significant prognostic factor is stage of the disease. Due to above mentioned factors there are no guidelines for therapy of this rare tumor. We present a case of 22-years-old patient initially treated with antibiotics under diagnosis of pelvic inflammatory disease. Due to persistent mass at left adnexa, she was indicated for diagnostic laparoscopy, converted to laparotomy and left adnexectomy with frozen section revealing unspecified malignant tumor of left ovary. A conservative operation was performed and, after diagnosis of SCCOHT was established, the patient was indicated for adjuvant chemotherapy.
- Klíčová slova
- SCCOHT - conservative surgery - chemotherapy.,
- MeSH
- diferenciální diagnóza MeSH
- dospělí MeSH
- hyperkalcemie * MeSH
- kombinovaná terapie MeSH
- lidé MeSH
- malobuněčný karcinom diagnóza diagnostické zobrazování terapie MeSH
- nádory vaječníků diagnóza diagnostické zobrazování terapie MeSH
- ovarektomie MeSH
- ultrasonografie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
OBJECTIVE: Detection of cancer stem cells (CSCs) in ovarian cancer, influence of CSCs on overall survival, disease free interval. Results in comparison with literature. DESIGN: Original study. SETTINGS: Department of Gynaecology and Obstetrics, Faculty Hospital Pilsen and Medical Faculty in Pilsen, Charles University, Šikls Institute of Pathology, Faculty Hospital Pilsen and Medical Faculty in Pilsen, Charles University. METHODS: 23 specimens of papillary-serous ovarian carcinoma and 4 specimens of endometroid ovarian carcinoma were included in the study. Specific antibodies to CD44 and CD133 antigens were used. Immunoreaction of both CD44 and CD133 was evaluated for the high power field. RESULTS: There was no significant correlation between CD44 expression and disease free interval and overall survival. CD133 expression was not evaluated due to an inadequate immunoreaction antibody - antigene. CONCLUSION: We did not find any statistically correlation between CD44 expression and overall survival and disease free interval in our series of patients with ovarian carcinoma. It seems to be better to use different antibody for CD133 detection.
- MeSH
- antigen AC133 MeSH
- antigeny CD44 metabolismus MeSH
- CD antigeny metabolismus MeSH
- dospělí MeSH
- epiteliální ovariální karcinom MeSH
- glykoproteiny metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádorové biomarkery metabolismus MeSH
- nádorové kmenové buňky imunologie metabolismus patologie MeSH
- nádory glandulární a epitelové diagnóza imunologie metabolismus MeSH
- nádory vaječníků diagnóza imunologie metabolismus MeSH
- peptidy metabolismus MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- antigen AC133 MeSH
- antigeny CD44 MeSH
- CD antigeny MeSH
- glykoproteiny MeSH
- nádorové biomarkery MeSH
- peptidy MeSH
- PROM1 protein, human MeSH Prohlížeč
Lichen sclerosus (LS) belongs to frequent non-neoplastic epithelial disorders of the vulva. LS is a disease of unknown ethiology, affecting mainly postmenopausal women. LS has a typical macroscopic pattern, and it is characterized with an intensive pruritus and dyspareunia. Patients with LS have a risk of scarring of external genitalia and risk of developing squamous cell carcinoma of the vulva (4-5%). Treatment of LS is usually long-term, repeated, and it is based on local potent corticosteroids. Frequent reccurences require repeated therapy. A close follow-up in a 6-months intervals and biopsy of all atypical lesions is required. Surgical treatment is rarely indicated in the management of LS. Follow-up at the specialized center is recommended.
- MeSH
- biopsie MeSH
- celosvětové zdraví MeSH
- diferenciální diagnóza MeSH
- incidence MeSH
- lichen sclerosus vulvy diagnóza epidemiologie MeSH
- lidé MeSH
- perineum patologie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
OBJECTIVE: Protein p16 as an important cell-cycle inhibitor is a promising diagnostic and prognostic factor of cervical dysplasia. In our study we evaluate the impact of p16 protein evaluation on management of cervical dysplasia. DESIGN: Retrospective study. SETTING: Department of Obstetrics and Gynecology, Medical Faculty Pilsen, Charles University Prague. METHODS: A retrospective study was performed on 122 consecutive patients with colposcopically-directed cervical biopsy (CDB) with following excisional procedure (LEEP or cold-knife conisation). P16 expression in the specimen from CDB was independently evaluated using immunohistochemistry in all patients. Relation among CDB histology, p16 expression, and final histology from excisional procedure was analysed. RESULTS: In our series, we identified 44 CIN 1 and 61 CIN 2/3 in CDB specimens. In the CIN 1 group, 15 cases (34.1%) were p16 negative and 29 (65.9%) cases were p16 positive. In CIN 1 p16 negative group, only 2 of 15 patients (13.3%) had CIN 2/3 in the final histology comparing to 19 of 29 patients (65.5%) in CIN 1 p16 positive group (statistically signifiant,p < 0,05; Wilcoxon test). In CIN 2/3 group, 60 (98.4%) specimen were p16 positive and 57 patients (93.4%) had also CIN 2/3 in the final histology. CONCLUSION: In our study of 122 patients with CDB we found that in group of CIN 1 patients, p16 evaluation had significant predictive value for final histology. In the group of patients with CIN 2/3, 98% specimens were p16 positive and therefore p16 evaluation had no prognostic impact on final histology. Prospective study is needed to confirm this data.
- MeSH
- dysplazie děložního hrdla * diagnóza epidemiologie metabolismus patologie MeSH
- inhibitor p16 cyklin-dependentní kinasy MeSH
- lidé MeSH
- nádorové proteiny chemie metabolismus MeSH
- nádory děložního čípku * diagnóza epidemiologie metabolismus patologie MeSH
- prognóza MeSH
- retrospektivní studie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- CDKN2A protein, human MeSH Prohlížeč
- inhibitor p16 cyklin-dependentní kinasy MeSH
- nádorové proteiny MeSH
